In 1957, the UK National Health Service (NHS) was just nine years old and already grappling with a very familiar problem – the rising cost of prescriptions. The drug bill at the time was £57 million, compared to the £17.4 billion spend in 2017 – clearly a different era. In June 1957, the government tasked the Committee on the Cost of Prescribing, led by Sir Henry Hinchliffe, to investigate, resulting in the Cost of Prescribing (Hinchliffe) report.
On 11 November 2019, the Health Economics Research Centre (HERC) is presenting a symposium to mark the 60th anniversary of the document. The report made a set of landmark recommendations, and the symposium will explore, 60 years on, what has changed. Do we face similar challenges today? What long-term recommendations to address the current challenges could be made by the government?
Many of the recommendations in the Hinchliffe report related to the generation, interpretation, and use of evidence on drug efficacy. These included recommendations on medical training, to include education on economical prescribing, and training to enable doctors to evaluate manufacturers’ claims for their drugs. The report accepts the importance of pharmaceutical industry investment in research and development, but wishes to curb “extravagant sales propaganda, some of which is undesirable”! Further, the report argues for establishment of a permanent expert body “to include men with business experience, an economist and a statistician” to advise on drug costs – presumably women were not invited to apply to be part of this forerunner of NICE?
As a member of the organising group for the symposium, I wanted to find out more about the discussion of the report in parliament, and delved into Hansard, the official record of UK Parliament proceedings. Surprisingly, given the subsequent impact of the report’s ideas, there is little mention of it. The report is mentioned in a debate on prescription charges on 13 July 1959, in which the Minister of Health, Derek Walker-Smith, describes the report as “a factor to be taken into account in the consideration of the relevant circumstances to which I then referred” – hardly a ringing endorsement.
Read more (Oxford Science Blog)
Find out more about the Symposium (HERC website)